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皮肤黑色素瘤的内脏转移模式:一项描述性研究。

Patterns of visceral metastasis in cutaneous melanoma: a descriptive study.

作者信息

Marcoval J, Ferreres J R, Martín C, Gómez S, Penín R M, Ochoa de Olza M, Fabra Á

机构信息

Servicio de Dermatología, IDIBELL, Hospital Universitari de Bellvitge, Barcelona, Spain.

出版信息

Actas Dermosifiliogr. 2013 Sep;104(7):593-7. doi: 10.1016/j.adengl.2012.12.006. Epub 2013 Jul 19.

Abstract

BACKGROUND AND OBJECTIVES

Some types of cancer tend to spread to certain organs. In the case of melanoma, uveal melanoma spreads almost exclusively to the liver, while cutaneous melanoma spreads to the liver and other organs. Although important advances have been made in our understanding of the molecular mechanisms underlying melanoma, few recent studies have focused on the patterns of visceral metastasis in cutaneous melanoma. The aim of this study was to retrospectively investigate whether clinicopathologic variants of cutaneous melanoma and primary tumor site might be associated with pattern and time of onset of metastasis to visceral sites, including the central nervous system (CNS).

MATERIALS AND METHODS

We included patients diagnosed with cutaneous melanoma between 1988 and 2009 with at least 2 years' follow-up.

RESULTS

Of the 1083 patients studied, 92 developed visceral metastasis. The CNS was affected in 21 cases, the lungs in 24, the liver in 17, the digestive tract in 7, and multiple organs simultaneously in 23. Metastasis to the lungs, the liver, and the digestive tract occurred within 5 years in most cases, while metastasis to the CNS and multiple organs occurred later (>5 years in 38% and 43% of cases, respectively).

CONCLUSIONS

Unlike uveal melanoma, cutaneous melanoma spreads to different organs without any particular predilection. We observed no significant associations between the site of visceral metastasis and either clinicopathologic variant or location of the primary tumor. Metastasis occurred within 5 years of diagnosis in most cases, but it can occur after 10 years.

摘要

背景与目的

某些类型的癌症倾向于扩散至特定器官。就黑色素瘤而言,葡萄膜黑色素瘤几乎仅扩散至肝脏,而皮肤黑色素瘤则扩散至肝脏及其他器官。尽管我们对黑色素瘤潜在分子机制的理解已取得重要进展,但近期很少有研究聚焦于皮肤黑色素瘤的内脏转移模式。本研究的目的是回顾性调查皮肤黑色素瘤的临床病理变异及原发肿瘤部位是否可能与内脏部位(包括中枢神经系统,CNS)转移的模式和起始时间相关。

材料与方法

我们纳入了1988年至2009年间诊断为皮肤黑色素瘤且至少随访2年的患者。

结果

在研究的1083例患者中,92例发生了内脏转移。中枢神经系统受影响的有21例,肺24例,肝脏17例,消化道7例,23例同时累及多个器官。大多数情况下,肺、肝脏和消化道的转移发生在5年内,而中枢神经系统和多个器官的转移发生较晚(分别有38%和43%的病例发生在5年之后)。

结论

与葡萄膜黑色素瘤不同,皮肤黑色素瘤扩散至不同器官,无任何特定偏好。我们未观察到内脏转移部位与临床病理变异或原发肿瘤位置之间存在显著关联。大多数转移发生在诊断后的5年内,但也可能在10年后发生。

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